Collectively, the pneumoconioses represent a spectrum of pulmonary diseases initiated by inorganic dust exposure. Although multiple humoral and cellular immune alterations have been demonstrated in these interstitial and commonly fibrotic lung diseases, the exact role of immune changes in disease pathogenesis presently is undefined. Insight into disease mechanisms may have to await the careful characterization of suitable animal models, along with analysis of local, human bronchopulmonary immune responses through the vehicle of bronchoalveolar lavage.